Philadelphia Reflections

The musings of a physician who has served the community for over six decades

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New topic 2019-04-09 16:04:33 description

Podiatrists Strike it Sort of Rich

Between the Civil and First World Wars, we had a flirtation with specialty hospitals. Usually small, they were often owned by physicians with a large specialty practice. As a preamble to the Flexner Report and development of medical centers, they often clustered around a larger general hospital. Thus, the Pennsylvania Hospital was surrounded by several small special hospitals, in an era generally ending with their absorption into some larger general hospital with a wider range of services. So I taught podiatrists for a while and went crosstown to teach future veterinarians. I wasn't paid, I received no title; I just taught because some staff member asked me to, as a small extension of the "rotating" internship concept. That veterinary hospital is still the only private veterinary school in the nation, all others are state schools. To complete the background, the School of Podiatry was in the building of the Skin and Cancer Hospital, a block away from the Babies Hospital. Of these, only podiatry expanded and was moved a few blocks away, under the supervision of Temple University. Others just withered away. The University of Pennsylvania absorbed the veterinary school, found a few wealthy families to pay for it, and moved closer to the farms which survived the shrinkage of agricultural workers to 2% of the workforce.

I have to suppose podiatry flourished while the others withered because podiatry patients have since grown abundant, insurable and smelly--you could make a living without as much competition. Like funeral parlors, I see them scattered around the city, often taking up abandoned mansions in formerly prosperous suburbs. The tools of this trade are the heavy clippers for fungus-thickened toenails, and the occupation was once satirized by Tom Stoppard in the preamble to"Rosenkrantz and Guildenstern are Dead". Stoppard himself missed the point of Rosenkrantz's monologue, which was that older people mostly went to a podiatrist because their backs were so stiff they couldn't reach their toenails themselves.

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